NCQA

JUNE 27, 2023

More states are contracting with managed care organizations (MCO) to provide Medicaid long-term services and supports (LTSS). How do we know if MCOs are delivering equitable, high-quality care to people receiving LTSS? Care Transitions: Individuals receiving LTSS experience smooth and safe transitions between care settings.

Medicaid 52

Medicaid Care Transition Quality Improvement Regulations 52

NASHP

MARCH 22, 2024

States are increasingly turning to capitated Medicaid managed care programs to deliver long-term services and supports (LTSS) to individuals with complex needs. California does cover skilled nursing facility care in its MLTSS program, but most personal care services (in-home supportive services) are provided under FFS.

Medicaid 75

Medicaid Nursing Medicare Integration 75

Home Health Care

APRIL 10, 2023

At-Home Health Care — Sparta Community Hospital’s home health segment — has made successful care transitions a priority in an effort to lower rehospitalizations and ER visits. Sparta Community Hospital is located in Southern Illinois and is a 25-bed full-service acute care medical facility.

Care Transition 98

Care Transition Hospitals Medicare Performance improvement 98

HIT Consultant

MARCH 8, 2022

Under the PHE, states must keep Medicaid enrollees continuously covered, irrespective of their circumstances. . By December 2021, enrollment in Medicaid and CHIP (Children’s Health Insurance Program) grew to a record high of more than 83 million individuals, primarily due to the continuous coverage requirements of the PHE.

Medicaid 98

Medicaid Primary Care Care Transition Federal Healthcare 98

Home Health Care

NOVEMBER 22, 2022

Last year was a record-breaking year for transaction volume and private-duty across the board, when you add both Medicaid and private pay,” he said last week, during a presentation at Home Health Care News’ Home Care Conference. It was known for Medicaid expansion. Home Health Care News’ Home Care Conference.

Home Care 104

Home Care Medicaid Medicare Care Transition 104

NASHP

AUGUST 5, 2024

CHWs are key to engagement, care coordination, and increasing access to clinical and support services for Medicaid enrollees from their communities. As such, states increasingly are pursuing Medicaid reimbursement options as part of a comprehensive CHW service financing approach, which is currently reliant on expiring grant programs.

Medicaid 52

Medicaid Primary Care Prevention Accountability 52

Sheppard Health Law

OCTOBER 27, 2021

On October 20, 2021, the Centers for Medicare and Medicaid (“ CMS ”) Innovation Center (“ Innovation Center ”) published a white paper detailing its vision for the next ten years: a health system that achieves equitable outcomes through high quality, affordable, person-centered care. Strategic Objective 2: Advance Health Equity.

Medicaid 52

Medicaid Medicare Accountable Care Accountability 52

NASHP

SEPTEMBER 22, 2022

The federal government has boldly detailed nearly 350 actions that agencies overseeing Medicare and Medicaid, Veterans Affairs, housing, labor, and more will take over the next three years to support caregivers. Hartford Foundation.

Medicaid 111

Medicaid Care Transition Medicare Quality Improvement 111

NASHP

SEPTEMBER 20, 2022

To identify emerging state aging policy priorities, NASHP — with support from the West Health Policy Center — conducted a series of key informant interviews with a wide range of state officials, including health and human services secretaries/commissioners, Medicaid directors, aging and disability directors, and legislators.

Medicaid 93

Medicaid Nursing Regulations Care Transition 93

Home Health Care

JANUARY 26, 2022

Patrick Blair, formerly of Bayada Home Health Care, has been named president and CEO by InnovAge’s board of directors. The appointment comes after reports that Colorado’s Department of Health Care Policy and Financing and the U.S. Centers for Medicare and Medicaid Services (CMS) stopped reimbursing InnovAge for new clients.

Regulations 98

Regulations Care Transition Medicaid Medicare 98

Bill Of Health

FEBRUARY 6, 2024

Code § 1396n and apply for § 1115 waivers identified as supportive of substance use prevention or treatment and care transitions for incarcerated persons.

Rehabilitation 122

Rehabilitation Care Transition Prevention Medicaid 122

NASHP

DECEMBER 6, 2024

In September, the Centers for Medicare and Medicaid Services (CMS) announced a new funding opportunity of $106.5 million in planning grants to support states in promoting continuity of care for people transitioning from incarceration to community. This project is a partnership between NASHP and The Health Reentry Project (HARP).

Medicaid 52

Medicaid Care Transition Medicare 52

Home Health Care

JUNE 9, 2022

The shift to value-based care. Connecting training with outcomes serves patients and staff, but the shift to value-based care means attention to outcomes is imperative as home-based care transitions to rewarding providers for the quality of the care they deliver.

Care Transition 104

Care Transition Quality of Care Accountability Home Care 104

Home Health Care

DECEMBER 6, 2023

ACHC initially focused on accrediting home health agencies, but over the years, it has expanded its scope to include other health care sectors such as hospice, hospital, pharmacy, DME, home care and renal dialysis.

Regulations 102

Regulations Care Transition Telemedicine Patient Safety 102

NASHP

NOVEMBER 17, 2023

For example, Washington’s family caregiver support program within its Medicaid 1115 waiver was built upon data from a state-only program for unpaid caregivers of adults with movement or cognitive limitations. The state evaluated the impact of expanding its family caregiver support program in 2012.

Medicaid 64

Medicaid Nursing Primary Care Hospitals 64

HIT Consultant

DECEMBER 15, 2021

The company’s comprehensive patient data will now enable Oak Street Health to simplify care collaboration, initiate timely care interventions post-discharge, and achieve value-based care goals in line with the Centers for Medicare and Medicaid Services Star Rating Program and Direct Contracting Model. “To

Urgent Care 52

Urgent Care Primary Care Care Transition Patient Experience 52

NASHP

FEBRUARY 27, 2023

As states are seeking sustainable financing models and partnerships that offer continued support for the CHW services beyond the COVID-19 pandemic, many are exploring Medicaid reimbursement models. APMs can apply to a specific clinical condition, a care episode, or a population.” What is an Alternative Payment Model?

Primary Care 52

Primary Care Medicaid Care Transition Medicare 52

Sequence Health

FEBRUARY 20, 2025

Effective communication during care transitions, along with proper medication reconciliation, is vital for preventing readmissions and improving overall patient outcomes. This program underscores the importance of improving care transitions to minimize patient readmissions within a 30-day timeframe post-discharge.

Hospitals 52

Hospitals Care Transition Primary Care Prevention 52

Sheppard Health Law

DECEMBER 12, 2022

The Centers for Medicare & Medicaid Services (CMS) Innovation Center continues to move forward with its “strategic refresh” initiative. Through this shift, CMS aims to examine and enhance payments for specialty care provided to Medicare beneficiaries. Value-Based Care and ACOs.

Accountable Care 52

Accountable Care Accountability Medicare Primary Care 52

HIT Consultant

OCTOBER 7, 2021

Value-based care, a model that rewards better patient health outcomes, has experienced a surge in interest amid heightened consumer awareness and among payers seeking to lower costs and stabilize reimbursement. The acceleration of the value-based care transition isn’t slowing; the good news is, it’s not too late to get started.

Healthcare 75

Healthcare Nursing Care Transition Accountability 75

NASHP

JUNE 22, 2022

The National Care Coordination Standards for CYSHCN, released by the National Academy for State Health Policy in October 2020, describe the importance of focusing care coordination quality measurement for pediatric populations on the extent to which patients’ and families’ goals and needs are met and burdens reduced. [8] Score – 12).

Doctors 52

Doctors Medicaid Quality of Care Healthcare Providers 52

NASHP

OCTOBER 22, 2021

Supporting the Continuum of Care for Serious Illness in Medicaid Managed Care October 25, 2021 / by Salom Teshale, Kitty Purington, Wendy Fox-Grage, and Mia Antezzo. Comprehensive care coordination. billion on chronic obstructive pulmonary disease (COPD) per year. Assessment and management of pain and other symptoms.

Medicaid 102

Medicaid Hospice Care Regulations Integration 102

NASHP

JUNE 22, 2022

Shared Plan of Care. Care Coordination Workforce. Care Transitions. public health, Medicaid, mental health) and other stakeholders (e.g., On the other hand, a health plan may use the guide to implement a high-quality screening and assessment process through primary care providers. State Medicaid agencies.

Care Transition 52

Care Transition Medicaid Doctors Regulations 52

NASHP

MARCH 29, 2024

Approaches include allowing family caregivers to receive Medicaid reimbursement , providing culturally competent trainings and peer supports, making respite care more accessible for caregivers, and offering behavioral health supports for caregivers. skilled nursing, home health care, behavioral health, etc.)

Medicaid 124

Medicaid Quality of Care Quality Assurance Nursing 124

NASHP

OCTOBER 12, 2024

Interest in expanding MOUD access in carceral settings and strengthening reentry supports have been bolstered by new federal flexibilities through state Medicaid 1115 demonstrations that allow Medicaid reimbursement for certain services provided to individuals during the 90 days before they are released from incarceration (see text box below).

Medicaid 59

Medicaid Prevention Care Transition Medicare 59

HIT Consultant

JUNE 22, 2022

Hospitals and health systems face mounting pressure to reduce unnecessary readmissions, particularly the Hospital Readmissions Reduction Program – a Centers for Medicare & Medicaid Services (CMS) value-based initiative – which penalizes hospitals with relatively higher rates of Medicare readmissions.

Hospitals 98

Hospitals Medicare Primary Care Care Transition 98

NASHP

DECEMBER 10, 2021

The information on this map comes from a 50-state survey of a variety of stakeholders, ranging from Medicaid officials to Community Health Workers, on their states’ approaches?to?integrating?CHWs ACO Accountable Care Organizations. MCO Managed Care Organizations. MCE Managed Care Entities. MHP Medicaid Health Plans.

Medicaid 122

Medicaid Primary Care Prevention Nursing 122

NASHP

NOVEMBER 29, 2021

Medicaid Reimbursement. Medicaid Reimbursement. Alabama does not reimburse for CHW services through its Medicaid program. Alaska Medicaid reimburses for CHW services through MCOs as authorized under the state plan. Arizona does not currently reimburse for CHW services through its Medicaid program.

Medicaid 52

Medicaid Primary Care Prevention Nursing 52

NASHP

JANUARY 20, 2025

As the federal government prepares to transition to a new administration, states are entering their legislative sessions, with some navigating Medicaid budget shortfalls and awaiting next steps at the federal level. States have pursued these waivers with the goal of reducing health care costs while improving access to health care.

Medicaid 88

Medicaid Care Transition Medicare Prevention 88

NASHP

AUGUST 9, 2021

Nearly every state that reviews pregnancy-related deaths has recommendations focusing on: Ensuring adequate insurance coverage and payment, Increasing early identification and referrals, Ensuring referrals and follow-up care, and/or. Expand Medicaid coverage for postpartum women. Increasing access to specific services.

Medicaid 52

Medicaid Prevention Primary Care Hospitals 52

NASHP

NOVEMBER 3, 2023

The State Plan also identified several evidence-based strategies to meet the benchmark established to improve home care workforce capacity and caregiving supports, including providing respite care, financial supports and investments in the direct care workforce, and caregiver support for those who have Alzheimer’s disease and dementia.

Home Care 69

Home Care Prevention Population Health Rehabilitation 69